CAJ | 학술논문

目的：探索儿童原发性肾病综合征(NS)蛋白尿与足突损伤间的关系。方法选择2013年9月至2014年3月于哈尔滨市儿童医院泌尿内科住院的20例原发性 NS 患儿为研究对象,并纳入肾病组(n=20)。选择同期于该院门诊体检的10例健康儿童为正常对照组(n=10)。研究组患儿均接受肾上腺糖皮质激素治疗。应用酶联免疫吸附试验(ELISA)方法检测肾病组患儿不同观察时刻及正常对照组儿童随机尿足细胞标志蛋白(PCX)、足细胞裂孔膜蛋白(nephrin)水平,采用免疫比浊法及比色法测定患儿尿蛋白及尿肌酐水平,并计算尿蛋白、尿肌酐比值。结果①肾病组患儿尿 PCX、nephrin 水平和尿蛋白、尿肌酐比值均显著高于正常对照组,且差异有统计学意义(t=2.612,2.843,2.972；P <0.01)。②肾病组患儿激素治疗期间尿 PCX、nephrin 水平和尿蛋白/尿肌酐比值总体均呈下降趋势。相邻观察时刻的尿 PCX 与nephrin 水平比较,差异均无统计学意义(P >0.05)。治疗第8天尿 PCX 和 nephrin 水平较治疗前显著下降,且差异有统计学意义(t=1.934,2.093；P <0.05)。治疗第6天尿蛋白、尿肌酐比值较第4天和治疗前显著下降,且差异也有统计学意义(t=2.042,2.120；P <0.05)。③尿 PCX、nephrin 水平分别与尿蛋白、尿肌酐比值呈正相关关系(r=0.91,0.92；P <0.01)。结论尿 PCX、nephrin 水平随 NS 的恢复而逐渐下降,与尿蛋白指标有良好的相关性,对其进行监测可动态观察足细胞变化,对判断肾小球的损伤及恢复情况有一定的临床意义。
목적：탐색인동원발성신병종합정(NS)단백뇨여족돌손상간적관계。방법선택2013년9월지2014년3월우합이빈시인동의원비뇨내과주원적20례원발성 NS 환인위연구대상,병납입신병조(n=20)。선택동기우해원문진체검적10례건강인동위정상대조조(n=10)。연구조환인균접수신상선당피질격소치료。응용매련면역흡부시험(ELISA)방법검측신병조환인불동관찰시각급정상대조조인동수궤뇨족세포표지단백(PCX)、족세포렬공막단백(nephrin)수평,채용면역비탁법급비색법측정환인뇨단백급뇨기항수평,병계산뇨단백、뇨기항비치。결과①신병조환인뇨 PCX、nephrin 수평화뇨단백、뇨기항비치균현저고우정상대조조,차차이유통계학의의(t=2.612,2.843,2.972；P <0.01)。②신병조환인격소치료기간뇨 PCX、nephrin 수평화뇨단백/뇨기항비치총체균정하강추세。상린관찰시각적뇨 PCX 여nephrin 수평비교,차이균무통계학의의(P >0.05)。치료제8천뇨 PCX 화 nephrin 수평교치료전현저하강,차차이유통계학의의(t=1.934,2.093；P <0.05)。치료제6천뇨단백、뇨기항비치교제4천화치료전현저하강,차차이야유통계학의의(t=2.042,2.120；P <0.05)。③뇨 PCX、nephrin 수평분별여뇨단백、뇨기항비치정정상관관계(r=0.91,0.92；P <0.01)。결론뇨 PCX、nephrin 수평수 NS 적회복이축점하강,여뇨단백지표유량호적상관성,대기진행감측가동태관찰족세포변화,대판단신소구적손상급회복정황유일정적림상의의。
Objective To identify the relationships between proteinuria and foot process damage of primary nephrotic syndrome(NS).Methods From September 2013 to March 2014,a total of 20 patients with primary NS were selected as the research group (n = 20)in Harbin Children′s Hospital.Meanwhile 10 healthy children were selected as normal control group (n = 10 ).The children in research group were treated with adrenal cortex hormone therapy.The levels of podocalyxin (PCX)and nephrin at different observation time in the nephropathy group and at random interval in normal control group were detected by enzyme-linked immunosorbent assay (ELISA)method.The serum levels of urine protein and urine creatinine were measured by the method of turbidimetric inhibition immuno assay and colorimetry.Results ① The levels of urinary PCX,nephrin and urine protein/creatinine in research group were significantly higher than those of the normal control group(t=2.612,2.843,2.972;P <0.01 ).②PCX,nephrin and urine protein/urine creatinine levels were decreased during the treatment in research group.There was no significant difference in urine PCX and nephrin between every couple of adjacent observation time (P > 0.05 ).The levels of urinary PCX and nephrin were significantly decreased between the eighth day and before treatment, and the differences were statistically significant(t =1.934,2.093;P <0.05 ).The levels of urinary protein/urine creatinine were significantly decreased between the sixth day and the forth day or before treatment,and the differences were also statistically significant(t=2.042,2.120;P <0.05).③PCX and nephrin levels were positively correlated with urine protein/urine creatinine levels (r=0.91,0.92;P <0.01).Conclusions The levels of PCX and nephrin decreased with the recovery of NS,and it had a good correlation with urinary protein index,carrying on a quantitative detection of dynamic observation podocyte changes.It has certain clinical significance for judging the glomerular damage and recovery.